decisionhealth Newsletters, decisionhealth - 2011 Issue 1 (January)
CMS: Some wellness visits were incorrectly denied, but contractors will reprocess claims
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Article Overview
This article covers a CMS correction involving automatic denials tied to annual wellness visit claims and the contractor response to those errors. It is relevant to Medicare billing staff, physician practices, and revenue cycle teams monitoring Medicare Administrative Contractor updates. The piece summarizes the scope of the issue, which contractors were identified in reports, and the general next steps CMS says affected providers may expect.
Why This Topic Matters
Practices billing Medicare annual wellness visits need to know whether prior denials may be reprocessed and whether their local contractor has issued guidance. The article helps readers distinguish a limited contractor-specific processing issue from a broader national problem.
What You Will Learn
- What CMS said about the claim processing issue affecting annual wellness visit denials
- Which Medicare contractors were mentioned as affected in the report
- How CMS described the reprocessing and provider follow-up process
- What providers were told to do while waiting for contractor guidance
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle managers
- Physician practices
- Medicare billing teams
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